Calcium channel blocker toxicity: Difference between revisions

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Calcium Channel Blocker Toxicity

Calcium channel blocker toxicity is a potentially life-threatening condition resulting from an overdose of calcium channel blockers (CCBs), a class of medications commonly used to treat hypertension, angina, and certain cardiac arrhythmias.

Pathophysiology

Calcium channel blockers work by inhibiting the influx of calcium ions through voltage-gated calcium channels in the heart and vascular smooth muscle. This action leads to decreased myocardial contractility, reduced heart rate, and vasodilation. In the case of an overdose, these effects are exaggerated, leading to severe hypotension, bradycardia, and potentially cardiogenic shock.

Clinical Presentation

Patients with calcium channel blocker toxicity may present with a variety of symptoms, including:

In severe cases, patients may develop cardiac arrest or multi-organ failure.

Diagnosis

Diagnosis of calcium channel blocker toxicity is primarily clinical, based on the history of ingestion and presenting symptoms. Laboratory tests may show elevated blood glucose levels and metabolic acidosis. ECG findings may include bradycardia and conduction delays.

Treatment

The management of calcium channel blocker toxicity involves several steps:

Initial Stabilization

Ensure adequate airway, breathing, and circulation.
Administer intravenous fluids to support blood pressure.

Specific Therapies

Calcium: Administer intravenous calcium (calcium chloride or calcium gluconate) to counteract the effects of calcium channel blockade.
Vasopressors: Use vasopressors such as norepinephrine to maintain blood pressure.
High-dose insulin therapy: Administer high-dose insulin and glucose to improve cardiac contractility and peripheral perfusion.
Lipid emulsion therapy: Intravenous lipid emulsion can be used as a "lipid sink" to sequester lipophilic drugs, as shown in the image.

Prognosis

The prognosis of calcium channel blocker toxicity depends on the amount ingested, the time to treatment, and the specific agent involved. Early recognition and aggressive treatment improve outcomes.

Related Pages

Cardiovascular disease A-Z

Most common cardiac diseases

A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z

A

B

Brown atrophy of the heart

C

D

E

H

A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z

I

K

Keshan disease

L

Loeffler endocarditis

M

N

Nonbacterial thrombotic endocarditis

O

P

R

S

A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z

T

Traumatic cardiac arrest

V

W

Waon therapy

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-'''Calcium Channel Blocker Toxicity'''
+== Calcium Channel Blocker Toxicity ==
-[[Calcium channel blockers]] (CCBs) are a class of medications that are frequently used in the treatment of [[hypertension]], [[angina]], and certain types of [[arrhythmia]]. However, an overdose or inappropriate use of these drugs can lead to a condition known as calcium channel blocker toxicity.
+[[File:LipidEmulsion.JPG|thumb|right|Lipid emulsion therapy is used in the treatment of calcium channel blocker toxicity.]]
-==Overview==
+'''Calcium channel blocker toxicity''' is a potentially life-threatening condition resulting from an overdose of [[calcium channel blockers]] (CCBs), a class of medications commonly used to treat [[hypertension]], [[angina]], and certain [[cardiac arrhythmias]].
-Calcium channel blocker toxicity is a serious medical condition that can result in life-threatening symptoms and complications. It occurs when an individual ingests a dose of a calcium channel blocker that is higher than the therapeutic level, leading to an excessive blockage of calcium channels in the body.
+== Pathophysiology ==
-==Pathophysiology==
+Calcium channel blockers work by inhibiting the influx of calcium ions through [[voltage-gated calcium channels]] in the [[heart]] and [[vascular smooth muscle]]. This action leads to decreased myocardial contractility, reduced heart rate, and vasodilation. In the case of an overdose, these effects are exaggerated, leading to severe [[hypotension]], [[bradycardia]], and potentially [[cardiogenic shock]].
-Calcium channel blockers work by inhibiting the influx of [[calcium ions]] into cardiac and smooth muscle cells, leading to a decrease in muscular contraction. In the event of an overdose, this inhibition becomes excessive, leading to a significant decrease in [[cardiac output]], [[hypotension]], and potentially fatal arrhythmias.
+== Clinical Presentation ==
-==Symptoms==
+Patients with calcium channel blocker toxicity may present with a variety of symptoms, including:
-The symptoms of calcium channel blocker toxicity can vary depending on the specific drug ingested and the amount. However, common symptoms include [[dizziness]], [[shortness of breath]], [[nausea]], and [[vomiting]]. In severe cases, individuals may experience [[seizures]], [[coma]], and potentially fatal [[cardiac arrest]].
+* Severe [[hypotension]]
+* [[Bradycardia]]
+* [[Dizziness]]
+* [[Syncope]]
+* [[Confusion]]
+* [[Hyperglycemia]]
-==Treatment==
+In severe cases, patients may develop [[cardiac arrest]] or [[multi-organ failure]].
-Treatment for calcium channel blocker toxicity is primarily supportive and includes [[gastric lavage]], administration of [[activated charcoal]], and close monitoring of vital signs. In severe cases, intravenous [[calcium gluconate]] or [[calcium chloride]] may be administered to counteract the effects of the calcium channel blocker.
+== Diagnosis ==
-==Prevention==
+Diagnosis of calcium channel blocker toxicity is primarily clinical, based on the history of ingestion and presenting symptoms. Laboratory tests may show elevated blood glucose levels and metabolic acidosis. [[Electrocardiogram|ECG]] findings may include bradycardia and conduction delays.
-Prevention of calcium channel blocker toxicity involves proper medication management, including taking the prescribed dose at the correct times and avoiding the use of these medications without a prescription.
+== Treatment ==
+The management of calcium channel blocker toxicity involves several steps:
+=== Initial Stabilization ===
+* Ensure adequate [[airway]], [[breathing]], and [[circulation]].
+* Administer [[intravenous fluids]] to support blood pressure.
+=== Specific Therapies ===
+* '''Calcium:''' Administer intravenous calcium (calcium chloride or calcium gluconate) to counteract the effects of calcium channel blockade.
+* '''Vasopressors:''' Use [[vasopressors]] such as [[norepinephrine]] to maintain blood pressure.
+* '''High-dose insulin therapy:''' Administer high-dose insulin and glucose to improve cardiac contractility and peripheral perfusion.
+* '''Lipid emulsion therapy:''' Intravenous lipid emulsion can be used as a "lipid sink" to sequester lipophilic drugs, as shown in the image.
+== Prognosis ==
+The prognosis of calcium channel blocker toxicity depends on the amount ingested, the time to treatment, and the specific agent involved. Early recognition and aggressive treatment improve outcomes.
+== Related Pages ==
+* [[Calcium channel blocker]]
+* [[Cardiac arrhythmia]]
+* [[Hypertension]]
+* [[Lipid emulsion therapy]]
+{{Toxicology}}
+{{Cardiology}}
 [[Category:Toxicology]]
 [[Category:Cardiology]]
-[[Category:Emergency medicine]]
-[[Category:Pharmacology]]
-{{medicine-stub}}
-{{toxicology-stub}}
-{{cardiology-stub}}
-{{emergency-medicine-stub}}
-{{pharmacology-stub}}
-{{No image}}